My girlfriend getting too thin?

[casual_cyclist]

Dr Maryanne Demasi, PhD responds to the reaction regarding her Catalyst episodes:

http://www.abc.net.au/catalyst/stories/3891150.htm

[winstonw]

I note Demasi's research specialty was Rheumatoid Arthritis.

She gained her PhD at the end of 2003.
At the beginning of 2004, she started 2 years as a speech writer for the Sth Australian Govt.
Since, she has worked in the media with 7 and ABC.

So in fact, the field in which she gained her PhD, she did not work in afterwards. This might explain why a pubmed search only returns two RA studies with her name. In my view, that casts her as inexperienced as a PhD can get, and I'd be immediately dubious of her grasp on study design and statistical analysis.

She is as lightweight as they come, and it's my personal opinion her role at Catalyst has more to do with her photogenicity.

[ball bearing]

I note Demasi's research specialty was Rheumatoid Arthritis.

She gained her PhD at the end of 2003.
At the beginning of 2004, she started 2 years as a speech writer for the Sth Australian Govt.
Since, she has worked in the media with 7 and ABC.

So in fact, the field in which she gained her PhD, she did not work in afterwards. This might explain why a pubmed search only returns two RA studies with her name. In my view, that casts her as inexperienced as a PhD can get, and I'd be immediately dubious of her grasp on study design and statistical analysis.

She is as lightweight as they come, and it's my personal opinion her role at Catalyst has more to do with her photogenicity.

This post sounds remarkably similar to 'shooting the messenger' to my lay ears.

I believe that the days of doctors' being afforded the presumption of omniscience are over. The drug company reps are often a source of a typical MD's drug education that far exceeds whatever formal training many medical men receive. Now that we are aware of the deliberate manipulation of research data engaged in by the drug companies their motivations and methods are suspect, to say the least.

[winstonw]

This post sounds remarkably similar to 'shooting the messenger' to my lay ears.

I believe that the days of doctors' being afforded the presumption of omniscience are over. The drug company reps are often a source of a typical MD's drug education that far exceeds whatever formal training many medical men receive. Now that we are aware of the deliberate manipulation of research data engaged in by the drug companies their motivations and methods are suspect, to say the least.

IME, most doctors foremost tell patients to adopt healthy lifestyles - regular exercise, healthy bodyfat %, regular relaxation and other stress mgt behaviors, sleep hygiene, balanced diet with lots of vege and fruit, whole grains, legumes, lower fat animal produce

However, 2/3's of Australians don't heed that advice. If you want to hold to conspiracy theories about drug companies, then to be fair you must also hold to a non doctor conspiracy of delusion of the masses regarding the profound benefits of lifestyle change to combat atherosclerosis. The first culprit in this conspiracy should be people/businesses who undermine the authority of health professionals, such as those who peddle natural therapies that claim to influence atherosclerosis no matter one's lifestyle.

[ball bearing]

If you want to hold to conspiracy theories about drug companies...

"Trial sans Error: How Pharma-Funded Research Cherry-Picks Positive Results [Excerpt]

Clinical trial data on new drugs is systematically withheld from doctors and patients, bringing into question many of the premises of the pharmaceutical industry—and the medicine we use..."

http://www.scientificamerican.com/artic ... ve-results" onclick="window.open(this.href);return false;

"...Almost one in three (29%) large clinical trials in the United States remain unpublished five years after they are finished, according to scientists writing in the British Medical Journal. Of those, 78% have no results at all in the public domain..."

http://www.rawstory.com/rs/2013/10/30/s ... -finished/" onclick="window.open(this.href);return false;

[march83]

IME, most doctors foremost tell patients to adopt healthy lifestyles - regular exercise, healthy bodyfat %, regular relaxation and other stress mgt behaviors, sleep hygiene, balanced diet with lots of vege and fruit, whole grains, legumes, lower fat animal produce

This is a very important point to remember - significant risk factors for CVD are widely accepted as being genetics, age, smoking, hypertension, obesity, physical inactivity, diabetes, and cholesterol levels. most of those risk factors can be controlled to some degree via lifestyle changes (age and genetics aside). when it comes down to it, and speaking in general terms, whether or not cholesterol is a cause or not for CVD is not so relevant if all other controllable risk factors are ignored - the patient obviously cares little about their health if all other controllable risk factors remain unchanged.

[casual_cyclist]

IME, most doctors foremost tell patients to adopt healthy lifestyles - regular exercise, healthy bodyfat %, regular relaxation and other stress mgt behaviors, sleep hygiene, balanced diet with lots of vege and fruit, whole grains, legumes, lower fat animal produce

This is a very important point to remember - significant risk factors for CVD are widely accepted as being genetics, age, smoking, hypertension, obesity, physical inactivity, diabetes, and cholesterol levels. most of those risk factors can be controlled to some degree via lifestyle changes (age and genetics aside). when it comes down to it, and speaking in general terms, whether or not cholesterol is a cause or not for CVD is not so relevant if all other controllable risk factors are ignored - the patient obviously cares little about their health if all other controllable risk factors remain unchanged.

I agree with this to an extent. Australia is very much a pill culture. There are a lot of people who don't want to do the work to change their health and expect it all to be fixed by a pill. Doctors have become used to prescribing to satisfy this demand and to an extent they are complicit to the extent that they do not give patients a lifestyle modification option first. However, this may be due to a Doctor's clinical experience that the lifestyle option is so rarely taken up that it is not even worth mentioning anymore. It would be a shame if that were true.

[kb]

Hmm. Agree with this, the emphasis should definitely be more to interventions that are generally healthy, beneficial and without side-effects, but I think compliance has to be factored into the efficacy of treatments as much as it sucks. Of course I'm completely lay in medical matters...

[wombatK]

]
IME, most doctors foremost tell patients to adopt healthy lifestyles - regular exercise, healthy bodyfat %, regular relaxation and other stress mgt behaviors, sleep hygiene, balanced diet with lots of vege and fruit, whole grains, legumes, lower fat animal produce

However, 2/3's of Australians don't heed that advice.

My experience is that several GP's never once mentioned the need to be more careful with my diet while I put on 25 kg too much
weight in my 40's. I don't know the reasons, but I do know there's no easy way to tell anyone "you're too fat". Doubly so if you
see them only once in a blue moon.

It takes a decade or two of bad living to set up the nasty cardiac disease/diabetes etc.,., during which time you
might have no reason to visit the doctor and no warning of how much damage you're accumulating. In educating
people early in life, you run into the trying to put an old head on young shoulders problem. It's very hard to convince
young males especially that they're not immortal and need to think more about health issues.

By the time the patient gets symptoms, bad habits are entrenched and very difficult to overcome. When so much of the
advertising around us is promoting over-consumption and poor nutritional choices, it's asking too much to think that
doctor's actions can fix the problem.

[matagi]

Interesting, my GP had no problems telling me I needed to lose weight at 7kg over (which gave me a BMI of 27.1)

A loss of 7 kilos gets me to a BMI of 24.5, so I'm surprised nobody said anything when you were 25 kilos over.

***Yes, I know the limitations of BMI, but in reality, the rolls of flab around my middle tell me I can't play the "muscled athlete" card.

[casual_cyclist]

Interesting, my GP had no problems telling me I needed to lose weight at 7kg over (which gave me a BMI of 27.1)

A loss of 7 kilos gets me to a BMI of 24.5, so I'm surprised nobody said anything when you were 25 kilos over.

***Yes, I know the limitations of BMI, but in reality, the rolls of flab around my middle tell me I can't play the "muscled athlete" card.

You have a good GP who cares about your health. When I was 10kg over, mine said: you're fine. Of course, carrying that much extra fat around my middle is not fine.

[skull]

You have a good GP who cares about your health. When I was 10kg over, mine said: you're fine. Of course, carrying that much extra fat around my middle is not fine.

That reminded me of a convo I had with an Army doc a long time ago.

We had come back from overseas, I struggled reintegrating back to normal life and got pretty sick, lost 25kg in about 12 weeks . Whilst in the Army I was pretty big am 183cm and weighed 95kg, not fat but a big gym junkie. Could have done to shred a bit more fat. I was finally admitted into hospital when in the last week I lost 5kg in 5days. So I knew something was up and the because that was our first week back at work they too realised that I was obviously in trouble. Anyway during a visit with the doc I was talking about my weight loss, he pretty much said your BMI was pretty high so I wouldn't be too concerned about losing the weight.

[casual_cyclist]

You have a good GP who cares about your health. When I was 10kg over, mine said: you're fine. Of course, carrying that much extra fat around my middle is not fine.

That reminded me of a convo I had with an Army doc a long time ago.

We had come back from overseas, I struggled reintegrating back to normal life and got pretty sick, lost 25kg in about 12 weeks . Whilst in the Army I was pretty big am 183cm and weighed 95kg, not fat but a big gym junkie. Could have done to shred a bit more fat. I was finally admitted into hospital when in the last week I lost 5kg in 5days. So I knew something was up and the because that was our first week back at work they too realised that I was obviously in trouble. Anyway during a visit with the doc I was talking about my weight loss, he pretty much said your BMI was pretty high so I wouldn't be too concerned about losing the weight.

Yeah, because rapid weight loss isn't a red flag . I know someone who had rapid, unexplained weight loss. He went from a slightly overweight BMI to "normal BMI" in a few month. Fortunately, his doctor was concerned, investigated and found he had prostate cancer. During treatment for that, his surgeon diagnosed him with acromegaly - a pituitary tumor. Both were diagnosed in time to be treated and he has made a full recovery.

[casual_cyclist]

The Statin Insanity

http://www.huffingtonpost.com/david-h-n ... _hp_ref=tw

Links to some amazing data:

Statin Drugs Given for 5 Years for Heart Disease Prevention (Without Known Heart Disease) http://www.thennt.com/nnt/statins-for-h ... t-disease/

98% saw no benefit
0% were helped by being saved from death
1.6% were helped by preventing a heart attack
0.4% were helped by preventing a stroke

Listed under Cardiac Interventions that Do work:

Mediterranean Diet for 5 Years for Heart Disease Prevention (Without Known Heart Disease) http://www.thennt.com/nnt/mediterranean ... t-disease/

98.3% saw no benefit
1.7% were helped by avoiding a stroke, heart attack, or death

Doesn't seem that compelling.

Mediterranean Diet for Secondary Prevention After Heart Attack: http://www.thennt.com/nnt/mediterranean ... tack-care/

The magnitude of this study’s results is astonishing. To compare saving a life post-heart attack with this diet (NNT= 30) and with statins (NNT=83) suggests that diet is nearly three times more powerful as a life-saving tool. A few factors make this particularly remarkable. Cancers were also reduced, while some authors have raised concerns about statins increasing cancer risk (without supporting evidence in the industry-sponsored trials to date). Imagine that the control group had been following a typical dietary pattern rather than the AHA recommended diet; the size of the effect could be even greater. Finally, the study suggests that cholesterol, which was not reduced by the Mediterranean diet, may not be as important a dietary consideration for heart disease prevention as currently thought and practiced.

[mikesbytes]

Hey Casual Cyclist, I notice in society they seem to think statistically, so 10Kg over is heaps better than average. However how we need to think is of how to better ourselves, I'm sure you agree?

[sogood]

IME, most doctors foremost tell patients to adopt healthy lifestyles ...
However, 2/3's of Australians don't heed that advice.

Interesting you raised this issue. Just today, I heard an interview on ABC-FM with someone who studied doctor-patient interactions. One of the standout was how patients' selective hearing plays into it. They pick out the bit they want to hear and ignores all the rest. When the blame game comes around, guess who's at fault... "I was never told".

[winstonw]

Interesting you raised this issue. Just today, I heard an interview on ABC-FM with someone who studied doctor-patient interactions. One of the standout was how patients' selective hearing plays into it. They pick out the bit they want to hear and ignores all the rest. When the blame game comes around, guess who's at fault... "I was never told".

ha... I could write a book on this.

I am old enough to value laying straight in bed every night. I therefore care less about political correctness with clients....which means if I think someone's msk pain would benefit from weight loss, I tell them, no hesitation. I get about 1 in 6 who think it inappropriate for a physio to go 'there', and who ask for follow up treatment with one of my associates. Of the other 5, maybe 2-3 actually take it on board and implement lifestyle change. And this highlights my issue with health care and our 'sensitive' culture now. Political correctness appeases the feelings of 1 in 6, at the expense of 3 in 6. Our political masters need to skill up on cost benefit analysis, when devising this stuff.

People need to understand their genes and nature are not influenced by tears, feelings, and sensitivities....same as bank accounts.

[matagi]

The selective hearing thing is the reason why important information should be written down when counselling patients. You can even go so far as to have it signed by both parties with a copy kept in the medical record.

FWIW, I have no trouble telling patients if I think their problems would benefit from weight loss. Interestingly, one of my colleagues has a chronic back problem brought about as the result of playing competition tennis. He also has a family history of heart disease. By my estimate, he is about 20kg overweight. Every time he complains about his back I tell him if he lost weight it would be better for his back. I usually get a cranky response. Now the thing is, this guy is a doctor. He KNOWS this stuff yet he isn't prepared to make the effort to do something about his weight. If a trained medical professional cannot make the effort, it is hardly surprising, that it is so difficult to motivate members of the general public to take positive steps to improve their health status.

[sogood]

Hand written note to patient... "You are fat and excessively overweight. You need to lose some excess weight pronto to reduce your disease risks. - Signed Your GP"

Just wait for the lawyers and news reporters to get hold of this, along with the cries of a "psychologically traumatised" victim... Sorry, most doctors want to do well for their patient but they aren't stupid. LOL

[simonn]

Seeing as there are quite a few health professionals reading this message... a couple of health food/god damn dirty hippie shops I have ordered from and liked on facebook seem to have posts on their facebook pages about saturated fat which implies it is now good for you, a health/slimming food in fact.

I was under the impression that the main problem with low fat is that the vast majority of food manufacturers just replaced the fat with sugar which has done nothing for health and may have even made things worse.

Before I let out an audible "sigh", you are still better off steaming or baking (or even boiling) food, than frying it in coconut oil? You are still better having a bean salad than tucking into fried sausages wrapped in fried bacon? I mean, getting the nutrients you need within a calorie limit is still important? Correct?

[im_no_pro]

Before I let out an audible "sigh", you are still better off steaming or baking (or even boiling) food, than frying it in coconut oil? You are still better having a bean salad than tucking into fried sausages wrapped in fried bacon? I mean, getting the nutrients you need within a calorie limit is still important? Correct?

For mine its the same approach as the BMI argument, assessing one meal rather than an entire diet isnt necessarily going to give an accurate result. The more I read the more value I am starting to place on balancing the source of the calories (fat/protein/carb) as well as the overall quantity of calories consumed. The hard part for mine is wading through all the hyperbole to determine what is a useful ratio for me (which may be different to what is useful for someone else). My favorite hyperbole from the last couple of days reading is here.

[hudnut]

Yep. As my Endo and Dietician say, people can can too carried away looking at one thing and lose the bigger picture.

To quote his extreme example, "As a diabetic you might want to focus on something with low carb and low GI. A bowl of fat fits that criteria, but you won't be here for long."

As an aside, this thread has gone a fair distance for something that seemed to be an excuse for DR to post pictures of his girlfriend in a bikini on the internet.

[John Lewis]

I had a mate who was well over weight.
When he returned one day from a visit to the doc he was a bit annoyed/unhappy.

Doc apparently said, "If you want to make old bones you'd better get rid of some of that lard."

A bit brutal perhaps but it was something of a wakeup call and he did proceed to do something
about it.

John

[casual_cyclist]

Hey Casual Cyclist, I notice in society they seem to think statistically, so 10Kg over is heaps better than average. However how we need to think is of how to better ourselves, I'm sure you agree?

Sorry for the late reply. I've been away, no internet. I just look at myself and my own risks. The science is clear that carrying excess abdominal fat puts me at a higher risk of... well... let me quote the live lighter web site:

Toxic fat, scientifically known as visceral fat, is the internal fatty tissue which surrounds vital organs such as the heart, liver, kidney and pancreas.

While the presence of excess fat under the skin (also known as subcutaneous fat) is often obvious, toxic fat is buried deep within us, making it harder to gauge how much fat is there.

Scientific studies have shown that toxic fat is more dangerous than the fat near the skin. Toxic fat is known to release dangerous levels of chemicals, including hormones, into the body. Because of this, excess toxic fat can lead to heart disease, type 2 diabetes and several cancers (including cancers of the oesophagus, pancreas, bowel and breast).

http://livelighter.com.au/the-facts/abo ... c-fat.aspx
My personal choice is not to live with those risks and I think a responsible doctor would inform their patients of those risks.

[AUbicycles]

As a mod courtesy - a post was removed. As an example or metaphor a was made with references to sexuality. In the rules we ask that sexuality is not a part of discussions as it is broadly not cycling related and this (and other topics) becomes a point of difference and upset.

Simply means discussion on topic without such references.